To investigate the effects of internal limiting membrane (ILM) peeling on visual field sensitivities in eyes with epiretinal membrane (ERM) accompanied by glaucoma with hemifield defect and myopia.
Retrospective clinical study
We reviewed clinical records of patients with ERM who underwent vitrectomy and ERM/ILM peeling. We first collected clinical data of eyes with ERM and glaucoma with hemifield defect. We recorded visual field sensitivities at 52 points and analyzed differences between before and after surgery. We then compared the changes in visual field sensitivity between glaucomatous and normal hemifields. Next, we collected ERM eyes without glaucoma and stratified them into two groups based on axial length (threshold = 26.0 mm). In these eyes, we also recorded visual field sensitivities at 52 points and analyzed differences between before and after surgery.
The study included 18 eyes with ERM and glaucoma with hemifield defect (11 men; mean age, 68.3 ± 7.2 years). These eyes showed significant sensitivity reductions at 5/26 points, mainly in the nasal area of the glaucomatous hemifield, whereas only 1/26 points exhibited significant sensitivity reduction in the normal hemifield. In eyes with axial length <26.0 mm and axial length ≥26.0 mm, 29 peripheral and seven superior peripheral points showed significant improvements in visual field sensitivities, respectively.
Visual field sensitivity reduction occurred mainly in the nasal region of the glaucomatous hemifield. Differences in axial length alone were not a prominent risk factor for reduced visual field sensitivity after ILM peeling in eyes with ERM.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Okamoto F, Okamoto Y, Hiraoka T, Oshika T. Effect of vitrectomy for epiretinal membrane on visual function and vision-related quality of life. Am J Ophthalmol. 2009;147:869–74.
Tanikawa A, Shimada Y, Horiguchi M. Comparison of visual acuity, metamorphopsia, and aniseikonia in patients with an idiopathic epiretinal membrane. Jpn J Ophthal. 2018;62:280–5.
Michels RG. Vitreous surgery for macular pucker. Am J Ophthalmol. 1981;92:628–39.
Margherio RR, Cox MS Jr, Trese MT, Murphy PL, Johnson J, Minor LA. Removal of epimacular membranes. Ophthalmology. 1985;92:1075–83.
Haas A, Seidel G, Steinbrugger I, Maier R, Gasser-Steiner V, Wedrich A, et al. Twenty-three-gauge and 20-gauge vitrectomy in epiretinal membrane surgery. Retina. 2010;30:112–6.
Kim M, Park YS, Lee DH, Koh HJ, Lee SC, Kim SS. Comparison of surgical outcome of 23-gauge and 25-gauge microincision vitrectomy surgery for management of idiopathic epiretinal membrane in pseudophakic eyes. Retina. 2015;35:2115–20.
Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M. Double staining with brilliant blue G and double peeling for epiretinal membranes. Ophthalmology. 2009;116:1370–6.
Schechet SA, DeVience E, Thompson JT. The effect of internal limiting membrane peeling on idiopathic epiretinal membrane surgery, with a review of the literature. Retina. 2017;37:873–80.
Chang WC, Lin C, Lee CH, Sung TL, Tung TH, Liu JH. Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: a meta-analysis. PLoS ONE. 2017;12:e0179105.
Diaz RI, Randolph JC, Sigler EJ, Calzada JI. Intraoperative grasp site correlation with morphologic changes in retinal nerve fiber layer after internal limiting membrane peeling. Ophthalmic Surg Lasers Imaging Retina. 2014;45:45–9.
Imamura Y, Ishida M. Retinal thinning after internal limiting membrane peeling for idiopathic macular hole. Jpn J Ophthalmol. 2018;62:158–62.
Scupola A, Grimaldi G, Abed E, Sammarco MG, Giudiceandrea A, Greco A, et al. Arcuate nerve fiber layer changes after internal limiting membrane peeling in idiopathic epiretinal membrane. Retina. 2018;38:1777–85.
Tsuchiya S, Higashide T, Sugiyama K. Visual field changes after vitrectomy with internal limiting membrane peeling for epiretinal membrane or macular hole in glaucomatous eyes. PLoS ONE. 2017;12:e0177526.
Terashima H, Okamoto F, Hasebe H, Matsuoka N, Fukuchi T. Vitrectomy for epiretinal membranes: ganglion cell features correlate with visual function outcomes. Ophthalmol Retina. 2018;2:1152–62.
Marcus MW, de Vries MM, Junoy Montolio FG, Jansonius NM. Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. Ophthalmology. 2011;118:1989–94.
Chihara E, Liu X, Dong J, Takashima Y, Akimoto M, Hangai M, et al. Severe myopia as a risk factor for progressive visual field loss in primary open-angle glaucoma. Ophthalmologica. 1997;211:66–71.
Chihara E. Myopia and diabetes mellitus as modificatory factors of glaucomatous optic neuropathy. Jpn J Ophthalmol. 2014;58:16–25.
Asrani S, Essaid L, Alder BD, Santiago-Turla C. Artifacts in spectral-domain optical coherence tomography measurements in glaucoma. JAMA ophthalmol. 2014;132:396–402.
Sakimoto S, Okazaki T, Usui S, Ishibashi T, Oura Y, Nishida K, et al. Cross-sectional imaging analysis of epiretinal membrane involvement in unilateral open-angle glaucoma severity. Invest Ophthalmol Vis Sci. 2018;59:5745–51.
Takagi ST, Kita Y, Yagi F, Tomita G. Macular retinal ganglion cell complex damage in the apparently normal visual field of glaucomatous eyes with hemifield defects. J Glaucoma. 2012;21:318–25.
Uchida N, Ishida K, Anraku A, Takeyama A, Tomita G. Macular vessel density in untreated normal tension glaucoma with a hemifield defect. Jpn J Ophthalmol. 2019;63:457–66.
The authors thank Drs. Shu Kachi, Tadasu Sugita, Ayana Suzumura, Rina Namba, and Kazuhisa Yamada for their important clinical suggestions and Ms. Kumi Fujiwara, Mr. Keigo Omori, and Ms. Waka Miyagi for technical assistance. The authors also thank Ryan Chastain-Gross, Ph.D., from Edanz Group (https://en-author-services.edanzgroup.com) for editing a draft of this manuscript. This work was partially supported by Grants-in-Aid for Scientific Research (C) (H.K., 19K09988) from JSPS KAKENHI (http://www.jsps.go.jp/), The Eye Research Foundation for the Aged (ERFA, H.K.), Charitable Trust Fund for Ophthalmic Research in Commemoration of Santen Pharmaceutical's Founder (H.K.), Bayer Retina Award Foundation (H.K.), and Ichihara International Scholarship Foundation (H.K.).
Conflict of interest
H. Kaneko, Honorarium for Lecturing (AMO, HOYA); N. Hirata, None; H. Shimizu, None; K. Kataoka, Honoraria for lecturing (Novartis, Bayer, Santen, Senju); N. Nonobe, Honoraria for lecturing (Novartis), Grant (Bayer); K. Mokuno, None; H. Terasaki, Grant, Honoraria for lecturing (Otsuka, Kowa, Santen, Senju, Alcon, Novartis, Bayer, Pfizer, Wakamoto, HOYA), Grant, Consultant fee (Nidek), Honoraria for lecturing (ZEISS, Nitten, Mitsubishi Tanabe, AbbVie, Nikon, Sanofi), Grant (TOMEY, AMO, Eisai), Consultant fee (Daiich-Sankyo).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Corresponding Author: Hiroki Kaneko
About this article
Cite this article
Kaneko, H., Hirata, N., Shimizu, H. et al. Effect of internal limiting membrane peeling on visual field sensitivity in eyes with epiretinal membrane accompanied by glaucoma with hemifield defect and myopia. Jpn J Ophthalmol 65, 380–387 (2021). https://doi.org/10.1007/s10384-021-00817-9
- Epiretinal membrane
- ILM peeling
- Visual field sensitivity
- Glaucoma with hemifield defect